TL;DR: Frequency of gonadal damage associated with Treo was significantly lower than that observed after Bu, and results need to be confirmed in a larger population.
TL;DR: In vitro results revealed that TrEO isolated from leaves of T. riparia and the pure compound 6,7-dehydroroyleanone display good activity against M. tuberculosis clinical isolates, including MDR isolate, with low cytotoxicity to murine macrophages, and this compound is a potential candidate for anti-TB drug.
TL;DR: TREO appears to be a promising candidate in terms of myeloablative, immunosuppressive and antimalignancy effects as well as low organ toxicity, and is expected to be registered as a novel conditioning agent in the near future.
Abstract: Importance of the field: Despite the marked development in the field of preparative regimens prior to hematopoietic stem cell transplantation (HSCT) over the last decade, the search for a superior conditioning agent is still continuing. In view of the literature reports, treosulfan (TREO), a structural analog of busulfan (BU), appears to be a promising candidate in terms of myeloablative, immunosuppressive and antimalignancy effects as well as low organ toxicity.Areas covered in this review: The article focuses on pharmacological activity, pharmacokinetics and toxicity of TREO. Compressed description of the drug-based conditioning prior to HSCT is also presented. Finally, TREO and BU characteristics are compared. Specific information of TREO concerning pediatric and adult patients is provided throughout the whole paper. The data refer predominantly to the publications, in majority from the last 10 years.What the reader will gain: According to our best knowledge, the paper is the first such comprehensive r...
TL;DR: There was wide interindividual variability in Treo AUC and CL (64 and 68%) which was not explained by any of the variables tested, and none of the Treo PK parameters were significantly associated with graft rejection or toxicity.
Abstract: A treosulfan (Treo)-based conditioning regimen prior to hematopoietic stem cell transplantation (HSCT) has been successfully used in treating hematological malignant and nonmalignant diseases. We report Treo pharmacokinetics (PK) in patients with thalassemia major undergoing HSCT (n = 87), receiving Treo at a dose of 14 g/m2/day. Median Treo AUC and clearance (CL) was 1,326 mg*h/L and 10.8 L/h/m2, respectively. There was wide interindividual variability in Treo AUC and CL (64 and 68%) which was not explained by any of the variables tested. None of the Treo PK parameters were significantly associated with graft rejection or toxicity; however, Treo CL <7.97 L/h/m2 was significantly associated with poor overall (hazard ratio (HR) 2.7, confidence interval (CI) (1.09–6.76), P = 0.032) and event-free survival (HR 2.4, CI (0.98–5.73), P = 0.055). Further studies in a larger cohort are warranted to identify the factors explaining the variation in Treo PK as well as to establish a therapeutic range of Treo for targeted dose adjustment to improve HSCT outcome.
TL;DR: The developed method was validated and demonstrated adequate accuracy and precision and the method was applied in clinical conditions to quantify the levels of TREO activation products in plasma of children undergoing HSCT.